Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-27T20:59:22.904Z Has data issue: false hasContentIssue false
  • English
  • Français

The end of tracheostomal stenosis? Introducing the fish mouth technique

Published online by Cambridge University Press:  25 November 2021

H S Gendeh ,
M Azman ,
M Mat Baki  and
A S Mohamed
H S Gendeh
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
M Azman
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
M Mat Baki*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
A S Mohamed
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
*
Author for correspondence: Professor Marina Mat Baki, Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia E-mail: [email protected] Fax: +603 9145 6647
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Post-laryngectomy tracheostomal stenosis is common and often results in an inadequate airway. Several techniques have been described to minimise tracheostomal stenosis. The star technique involves an ‘X’ incision with four flaps sutured into the trachea. The petal technique involves two inferior flaps on either side being sutured into the trachea. The authors combined the star and petal techniques, resulting in an innovative fish mouth technique.

Methods and results

This innovation involves two lateral skin flaps being sutured into an incision on either side of the lateral wall of the trachea. This results in an elongated, broadened and elliptical tracheostoma, mimicking that of a fish mouth.

Conclusion

Benefits of the fish mouth technique include adequate stoma size for respiration, easier clearing of secretions, self-sufficiency without a stent, easier cleaning of a tracheoesophageal voice prosthesis, and stoma occlusion for voice production. The fish mouth technique is easily reproducible and suitable for those with a voice prosthesis.

Keywords

LarynxLaryngectomyConstrictionTracheaSurgical Flaps
Type
Short Communications
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 4 , April 2022 , pp. 368 - 372
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Professor M Mat Baki takes responsibility for the integrity of the content of the paper

References

Griffith, GR, Luce, EA. Tracheal stomal stenosis after laryngectomy. Plast Reconstr Surg 1982;70:694–8CrossRefGoogle ScholarPubMed
Kuo, M, Ho, CM, Wei, W, Lam, KH. Tracheostomal stenosis after total laryngectomy: an analysis of predisposing clinical factors. Laryngoscope 1994;104:59–63CrossRefGoogle ScholarPubMed
Lam, KH, Wei, WI, Wong, J, Ong, GB. Tracheostome construction during laryngectomy—a method to prevent stenosis. Laryngoscope 1983;93:212–15Google Scholar
Lucioni, M, Rizzotto, G, Pazzaia, T, Serafini, I. Plastic tracheostomal-widening procedure: the “petal” technique. Acta Otorhinolaryngol Ital 2003;23:291–6Google ScholarPubMed
Capper, R, Bradley, PJ. Etiology and management of tracheostomal stenosis. Curr Opin Otolaryngol Head Neck Surg 2002;10:123–8CrossRefGoogle Scholar
Montgomery, WW. Stenosis of tracheostoma. Arch Otolaryngol 1962;75:76–9CrossRefGoogle ScholarPubMed
Parell, GJ, Becker, GD. Comparison of absorbable with nonabsorbable sutures in closure of facial skin wounds. Arch Facial Plast Surg 2003;5:488–90CrossRefGoogle ScholarPubMed